Predicting Inadequate Response to Acute Migraine Medication: Results From the <scp>A</scp>merican Migraine Prevalence and Prevention (<scp>AMPP</scp>) Study

Lipton, Richard B.; Munjal, Sagar; Buse, Dawn C.; Fanning, Kristina M.; Bennett, Alix; Reed, Michael L.

doi:10.1111/head.12941

Cited by 73 publications

(108 citation statements)

References 32 publications

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“…Cutaneous allodynia has been associated with an increased risk of attack recurrence and migraine chronicity . Cutaneous allodynia also predicts inadequate 2‐hour pain‐free and 24‐hour pain relief outcomes . Diagnostic vigilance remains important, and all consulting patients, especially women, should be queried about the presence of allodynia.…”

Section: Discussionmentioning

confidence: 99%

Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences

Lipton

Munjal²,

Alam³

et al. 2018

Headache

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125

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Objectives To summarize the baseline methods for the Migraine in America Symptoms and Treatment (MAST) Study and evaluate gender differences in sociodemographics and headache features; consultation and diagnosis patterns; and patterns of acute and preventive treatment use for migraine among study participants. Background The MAST Study is a longitudinal, internet‐based panel study of symptoms, approaches to management, and unmet treatment needs among US adults with migraine. This analysis focuses on the initial cross‐sectional survey, conducted beginning in 2016, and is intended to update results from earlier national epidemiologic surveys of people with migraine in the United States. Methods Respondents to the MAST Study were recruited from a US nationwide online research panel. Stratified random sampling identified a representative cohort of adults (aged ≥18 years). We administered a validated diagnostic screener based on modified ICHD‐3 beta criteria to identify individuals with migraine averaging at least 1 monthly headache day (MHD) over the previous 3 months. A baseline assessment evaluated sociodemographic and headache features, patterns of consultation and diagnosis, and use of acute and preventive medications for migraine. Frequency data and chi‐square contrasts (P < .05) were used to compare respondents based on gender. Results Baseline survey data (N = 95,821) identified 18,353 respondents who met criteria for migraine, including 15,133 (women n = 11,049, men n = 4084) reporting at least 1 MHD for the preceding 3 months. The mean age of the sample was 43.1 (13.6) years; 73.0% of respondents were women, and 81.0% were Caucasian. Compared with men, women were younger (46.1 vs 42.0 years; P < .001); had more MHDs (5.6 vs 5.3; P < .001); and were more likely to report moderate or severe headache‐related disability (45.9% vs 35.8%; P < .001) and cutaneous allodynia (43.7% vs 29.5%; P < .001). The lifetime rate of medical consultation for headache was 79.8% overall and slightly higher in women than in men. Women were more likely than men to have been diagnosed with migraine (48.3% vs 38.8%, P < .001). While 95.1% of people with migraine currently used acute treatment, the majority (58.9%) used over‐the‐counter (OTC) drugs to the exclusion of prescription drugs, while 11.3% used exclusively prescription drugs, and 20.5% used both. Among acute prescription medication users, women were more likely than men to take triptans (17.7% vs 14.3%, P < .001), while men were more likely than women to take opioids (14.5% vs 9.2%, P < .001). Oral formulations were used predominately (92.7% of the medication users), but men were more likely to use nasal sprays (13.6% vs 9.4%, P < .001) and injectables (7.9% vs 3.4%, P < .001). Men (14.5%) were also significantly more likely than women (10.4%) to be taking daily oral preventive medication (P < .001). Conclusions The MAST Study identified a large sample of women and men with migraine from a sampling frame that broadly resembles the US population. Low participation r...

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Section: Discussionmentioning

confidence: 99%

Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences

Lipton

Munjal²,

Alam³

et al. 2018

Headache

Self Cite

125

192

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“…In the case of migraine, a recent study showed that comorbid depression worsens the responsiveness for acute migraine treatment in a large population sample with episodic migraine (57). Thus, understanding the neurobiological background of this exceptionally high and specific comorbidity between migraine and depression may improve our treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression

et al. 2017

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IntroductionMigraine and depression frequently occur as comorbid conditions, and it has been hypothesized that migraine with and without depression may have a different genetic background. A distinct personality trait constellation has been described in migraineurs. Less attention, however, was paid to personality differences in migraineurs with and without depression which may also shed light on differences in the neurobiological, background. The aim of our study was to investigate big five personality traits, headaches, and lifetime depression (DEP) in a large European general population sample.MethodsRelationship between DEP, Big Five Inventory personality traits, and headaches identified by the ID-Migraine Questionnaire were investigated in 3,026 individuals from Budapest and Manchester with multivariate and logistic regression analyses.ResultsBoth DEP and migraine(ID) showed differences in personality traits. Neuroticism was an independent risk factor for both conditions while a significant interaction effect appeared between the two in the case of openness. Namely, subjects with migraine(ID) and without DEP scored higher on openness compared to those who had depression.ConclusionWhile we confirmed previous results that high neuroticism is a risk factor for both depression and migraine, openness to experience was significantly lower in the co-occurrence of migraine and depression. Our results suggest that increased openness, possibly manifested in optimal or advantageous cognitive processing of pain experience in migraine may decrease the risk of co-occurrence of depression and migraine and thus may provide valuable insight for newer prevention and intervention approaches in the treatment of these conditions.

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“…In this study of persons with migraine, triptan users had favorable outcomes in comparison with the NSAID, opioid, and barbiturate treatment groups for the 2hPF and 24hPR outcome measures. In addition, the presence of allodynia significantly increased the likelihood of an inadequate response to treatment for the 2hPF and the 24hPR outcome measures, but not – as in our prior analysis where medications groups were combined – for the 24hSPR outcome. These results are consistent with some human treatment studies as well as laboratory research .…”

Section: Discussionmentioning

confidence: 59%

“…In addition, the presence of allodynia significantly increased the likelihood of an inadequate response to treatment for the 2hPF and the 24hPR outcome measures, but not – as in our prior analysis where medications groups were combined – for the 24hSPR outcome. These results are consistent with some human treatment studies as well as laboratory research . In addition to allodynia, significant predictors of inadequate response to acute treatment included higher pain intensity (triptans, NSAIDs, opioids) and greater monthly headache‐day frequency (triptans, NSAIDs, opioids, and ergot alkaloids).…”

Section: Discussionmentioning

confidence: 59%

“…In comparing early with delayed treatment of acute attacks in patients with allodynia, Landy et al found that sumatriptan 100 mg oral tablets failed to produce a PF response after allodynia had developed and central sensitization was established . More recent research confirmed and extended these findings by demonstrating that cutaneous allodynia increases the risk of inadequate acute treatment outcomes on a number of clinically meaningful endpoints, including 2‐hour PF (2hPF), 24‐hour pain response (24hPR), and 24‐hour sustained pain response among those with an adequate 2hPF response (24hSPR) . Other factors associated with acute treatment response include the intensity of pain at the time of treatment and the interval from headache onset to treatment.…”

Section: Introductionmentioning

confidence: 99%

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Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study

et al. 2017

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The use of triptan medication was associated with significantly better 2hPF (except vs ergot alkaloids) and significantly better 24hPR outcomes compared with other acute medication categories. The presence of allodynia significantly increased the likelihood of an inadequate treatment response for both of these outcomes. Triptan use was generally associated with the best outcomes. Because allodynia was associated with inadequate outcomes for all medication groups, we suggest that allodynia is an area of unmet treatment need.

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Predicting Inadequate Response to Acute Migraine Medication: Results From the American Migraine Prevalence and Prevention (AMPP) Study

Cited by 73 publications

References 32 publications

Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences

Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences

Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression

Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study

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